Pääkkönen Markus
The Division of Diseases of the Musculoskeletal System, University of Turku and CoE TYKS ORTO, Turku University Hospital, Finland.
J Wrist Surg. 2021 Jun 29;11(3):269-271. doi: 10.1055/s-0041-1730345. eCollection 2022 Jun.
Open or arthroscopic partial resection of the elongated ulnar styloid is the surgical treatment of choice for ulnar styloid impaction syndrome. A patient with a severely elongated processus styloideus ulnae (PSU) with a chronic impaction of the distal-radial margin against the triquetrum suffered a traumatic triangular fibrocartilage complex (TFCC) Palmer 1B rupture and DRUJ instability. The length of the PSU was 9 mm. After failed conservative treatment, a partial oblique arthroscopic resection of the PSU and simultaneous TFCC reinsertion were performed with uneventful recovery. Arthroscopic resection has emerged as an alternative to the traditional open PSU resection for the treatment of styloid impaction syndrome. A transverse resection is described as the treatment of choice. Regarding the extent of resection subtotal ligament sparing resection or resection to the lower margin have been suggested. Surgical planning of PSU resection should take into consideration the anatomy of the impingement. The extent of resection should be planned individually, and sometimes an oblique resection may be the preferred option.
开放或关节镜下尺骨茎突延长部分切除术是治疗尺骨茎突撞击综合征的首选手术方法。一名尺骨茎突（PSU）严重延长且桡骨远端边缘长期撞击三角骨的患者，发生了创伤性三角纤维软骨复合体（TFCC）帕尔默1B型破裂和下尺桡关节不稳。PSU长度为9毫米。保守治疗失败后，进行了PSU部分斜行关节镜下切除术并同时进行TFCC重新植入，恢复顺利。关节镜下切除术已成为治疗茎突撞击综合征的传统开放PSU切除术的替代方法。横向切除术被描述为首选治疗方法。关于切除范围，有人建议进行保留韧带的次全切除术或切除至下缘。PSU切除术的手术规划应考虑撞击的解剖结构。切除范围应个体化规划，有时斜行切除术可能是首选方案。
